Virve Marionneau, Sara Havuaho, Nina Jokirinne, Aino Lahtinen
{"title":"Gambling consumption and socio-demographic characteristics among help-seekers with gambling-related debt.","authors":"Virve Marionneau, Sara Havuaho, Nina Jokirinne, Aino Lahtinen","doi":"10.1177/14034948261488598","DOIUrl":"https://doi.org/10.1177/14034948261488598","url":null,"abstract":"<p><p><i>Aims:</i> Indebtedness is prevalent among people with gambling problems. However, little research has focused on socio-demographic characteristics and gambling consumption patterns of individuals who finance their gambling with loans. This study aims to identify how debt-financed gambling is associated with socio-demographics and gambling consumption among help-seekers in Finland. <i>Methods:</i> We analysed gambling consumption and socio-demographic characteristics among help-seekers who use debt money to gamble. The analysis is based on data collected by the Finnish gambling helpline Peluuri across 2019-2022 (<i>N</i> = 4202). We used ridge regression with bootstrap analysis to conduct the analysis. <i>Results:</i> 39.11 % of help-seekers reported gambling with debt money. Gambling with debt was the most prevalent in 2019 and reduced in subsequent years, most notably after 2020. Gambling-related debt was more prevalent among 35- to 54-year-old people and those active in the labour market. Online gambling and poker were associated with debt. <b><i>Conclusions:</i> The results show that risk factors for gambling-related indebtedness may be different than risk factors for gambling disorder and other harms. Interventions are needed to limit the possibility of accumulating gambling-related debt. Notably, population-level interventions, such as financial literacy campaigns and limiting the availability of instant loans and harmful gambling products, are needed to protect public health.</b></p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"14034948261488598"},"PeriodicalIF":1.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Loneliness, living alone and mental well-being: findings from a population-based study in Sweden.","authors":"Malin Knutz, Mikael Jern, Anu Molarius","doi":"10.1177/14034948261479493","DOIUrl":"https://doi.org/10.1177/14034948261479493","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the association between loneliness, living alone and mental well-being among Swedish adults.</p><p><strong>Methods: </strong>The study is based on 6315 men and women aged 18 years or older responding to a population survey in 2022 (overall response rate 45%). A short version of the Warwick Edinburgh Mental Well Being Scale was used to measure mental well-being. The associations between loneliness, living alone and mental well-being were analysed using multiple logistic regression, adjusting for gender, age group, educational level, economic difficulties, social support, risk consumption of alcohol and longstanding illness.</p><p><strong>Results: </strong>Overall, the majority of the study population did not feel lonely, with 63.5% living with someone and 16.1% living alone. The proportion reporting loneliness, in total 20.4%, was about the same irrespective of whether the respondent lived with someone (10.7%) or was living alone (9.7%). More women than men reported loneliness, living alone and poor mental well-being. The youngest age group, 18-29 years, reported the highest levels of loneliness and poor mental well-being. Loneliness was independently associated with poor mental well-being, and the association was as strong among those who lived alone as among those who lived with someone.</p><p><strong>Conclusions: </strong>\u0000 <b>Loneliness was associated with poor mental well-being irrespective of living alone or not. Public health actions aiming to reduce loneliness and strengthen mental well-being in the general population need to address all age groups, in particular young adults and those who live with someone but still feel lonely.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"14034948261479493"},"PeriodicalIF":1.7,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Associations between insomnia and body mass index among the general Norwegian adult population: The Tromsø Study 2015-2016.","authors":"Suprima Sapkota, Jonas Johansson, Sweta Tiwari","doi":"10.1177/14034948261486908","DOIUrl":"https://doi.org/10.1177/14034948261486908","url":null,"abstract":"<p><p><i>Aims:</i> Insufficient sleep and increasing body mass index (BMI) are two emerging, and often related, public health concerns. Limited attention has been given to how insomnia is associated with BMI, particularly in subarctic regions with extreme seasonal climate and daylight differences. We aimed to investigate the association between insomnia and BMI among community-dwelling residents of Tromsø, Norway stratified by sex. <i>Methods</i>: This cross-sectional study was based on data from the seventh survey of the Tromsø Study (Tromsø7). We included 15,364 participants aged 40-65 years, who had complete BMI measurements and insomnia questionnaires. Sex-stratified multiple linear regression analyses were conducted to assess the association between insomnia and BMI. Socioeconomic, lifestyle, health, and biological factors were included as covariates. <i>Results</i>: The overall prevalence of insomnia was 29.7%, with a higher prevalence among women (33.9%) compared with men (25.0%). The association between insomnia and BMI was statistically significant for both sexes. In the final multivariable model, compared with sex-specific non-insomniacs, insomniacs had on average 0.43 kg/m<sup>2</sup> (95% confidence interval (CI) 0.21 to 0.64) higher BMI among men and 0.27 kg/m<sup>2</sup> (95% CI 0.41 to 0.51) higher BMI among women. <b><i>Conclusions:</i> This study demonstrates a significant association between insomnia and BMI in both sexes within the Tromsø population and can be a basis for longitudinal and experimental studies investigating causality and evaluation of the association between insomnia and BMI.</b></p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"14034948261486908"},"PeriodicalIF":1.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ann-Sofi Ellertsson, Joakim Ekstrand, Gita Hedin, Christina Sandlund, Pernilla Garmy
{"title":"Difficulties falling asleep and psychosocial factors among Swedish adolescents aged 11-15 years: A population-based study.","authors":"Ann-Sofi Ellertsson, Joakim Ekstrand, Gita Hedin, Christina Sandlund, Pernilla Garmy","doi":"10.1177/14034948261485372","DOIUrl":"https://doi.org/10.1177/14034948261485372","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the associations of difficulties falling asleep with problematic social media use, cyberbullying, and mental well-being among Swedish adolescents aged 11-15 years and to explore age-related differences while adjusting for gender and perceived family financial situation.</p><p><strong>Methods: </strong>This study employed a large population-based cross-sectional design based on data from the Swedish sample of the Health Behaviour in School-aged Children survey. The sample included 40,748 adolescents aged 11, 13, and 15 years. Descriptive and bivariate analyses were conducted, followed by binary logistic regression analyses.</p><p><strong>Results: </strong>Difficulties falling asleep more than once a week were associated with problematic social media use, cyberbullying, lower mental well-being, and a less favorable family financial situation across all age groups. Among the psychosocial factors, lower mental well-being exhibited the strongest association with difficulties falling asleep, with approximately threefold higher odds among 11-year-olds and fourfold higher odds among 13- and 15-year-olds. Problematic social media use was more strongly associated with difficulties falling asleep in younger adolescents, while exposure to cyberbullying was linked to roughly twofold higher odds across all ages; cyberbullying perpetration was associated with difficulties falling asleep mainly among 11- and 13-year-olds.</p><p><strong>Conclusions: </strong>\u0000 <b>The study reveals that difficulties falling asleep among adolescents are associated with problematic social media use and lower mental well-being, suggesting that interventions targeting difficulties falling asleep and healthy digital media use in early adolescence might be an important strategy to promote mental well-being.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"14034948261485372"},"PeriodicalIF":1.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Line Balslev, Marie Weinreich Petersen, Christian Østergaard Knudsen, Jeanette Birkedal Kühnel, Carsten Krogh Jørgensen, Henrik Bjarke Vægter, Kirsten Fonager, René Børge Korsgaard Brund
{"title":"Geographical variation in access to specialized treatment of functional somatic disorders-a cross-sectional study.","authors":"Line Balslev, Marie Weinreich Petersen, Christian Østergaard Knudsen, Jeanette Birkedal Kühnel, Carsten Krogh Jørgensen, Henrik Bjarke Vægter, Kirsten Fonager, René Børge Korsgaard Brund","doi":"10.1177/14034948261419204","DOIUrl":"https://doi.org/10.1177/14034948261419204","url":null,"abstract":"<p><strong>Background: </strong>Social and geographic inequalities in access to health care are well-documented. Patients with lower socioeconomic status often receive less specialized care, and geographical distance to treatment centers can further limit access-especially for vulnerable groups. Functional somatic disorders (FSDs), affecting approximately 15% of Danish adults, are frequently associated with social disadvantage and complex health care needs. Despite national efforts to provide equal access through regional treatment centers, potential disparities in diagnosis and treatment due to geographical variation remain underexplored.</p><p><strong>Objective: </strong>To investigate geographical variation in referral to and initiation of specialized treatment for severe FSDs and, secondarily, to describe individual and organizational characteristics that may influence access across regions.</p><p><strong>Methods: </strong>A three-part cross-sectional study was conducted using data from five Danish administrative health registers and the national clinical database, FuncData (1 February 2019-31 December 2022). All Danish citizens aged 18-65 were included. Patients with FSD was calculated by identifying patients discharged from hospitals with a symptom diagnosis. Prevalence of FSD, referral, and treatment initiation at Centers for Functional Somatic Disorder (CFDs) were calculated at municipality level. The association between sociodemographic characteristics and access to CFDs was analyzed and reported as relative risk.</p><p><strong>Results: </strong>The prevalence of FSD was 6%; of those, 1% was referred to a CFD and 50% initiated treatment. Geographical variations were found across the Danish municipalities. The prevalence of FSD ranged from 3.5% to 9.8%, generally lower near CFDs. Referrals ranged from 0% to 2.5%, and treatment initiation among referred patients from 0% to 100%, both lowest in municipalities that were far from CFDs. Patients with FSD were more likely to be older, female, socioeconomically disadvantaged, and less likely to have a partner.</p><p><strong>Conclusions: </strong>\u0000 <b>The study revealed geographical variations in the prevalence of FSD, referral to, and initiating specialized treatment across municipalities in Denmark. Differences were also observed for age, sex, and various socioeconomic factors, which may be part of the reason for the variation found between the municipalities.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"14034948261419204"},"PeriodicalIF":1.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helene Moustgaard, Frederikke Hørdam Gronemann, Marie Birkvig Raft, Terese Høj Jørgensen, Merete Osler
{"title":"Association of major depression with return to work and changes in employment rate across sociodemographic municipality characteristics: A register-based cohort study.","authors":"Helene Moustgaard, Frederikke Hørdam Gronemann, Marie Birkvig Raft, Terese Høj Jørgensen, Merete Osler","doi":"10.1177/14034948261485828","DOIUrl":"https://doi.org/10.1177/14034948261485828","url":null,"abstract":"<p><strong>Aims: </strong>We examined whether the association between depression and return to work (RTW) varied by municipality characteristics.</p><p><strong>Methods: </strong>In this nationwide register-based cohort study (2012-2018), adults aged 25-55 years with a first-time in- or outpatient contact for depression were matched 1:3 by birth year and sex to the general population. For comparison, parallel cohorts were established for first-time antidepressant users and individuals with cancer. Labour market affiliation was tracked from 1 year before to 3 years after diagnosis. Municipalities were characterized by urbanicity, unemployment level, and tax revenue. Among individuals outside the workforce, Cox proportional hazard regression estimated hazard ratios (HR) for RTW (early and late), comparing depression and reference groups, with interaction by municipality characteristics. Difference-in-difference analyses assessed absolute changes in the proportion in work, with parallel analyses for antidepressant use and cancer.</p><p><strong>Results: </strong>In the main analyses, HRs of RTW varied by urbanicity. The smallest difference (depression vs. reference group) was observed in capital municipalities (early HR 0.54, 95% confidence interval (CI) (0.51, 0.57)), late HR 0.72 (0.68, 0.75)) while larger differences were seen in upland (early HR 0.38 (0.35, 0.42)) or rural municipalities (late HR 0.59, 95% CI (0.55, 0.63)). Absolute workforce loss ranged from -9.6% (95% CI ( -10.7%, -8.4%)) in capital to -13.6% (-15.3%, -11.9%) in big city municipalities. A similar variation by urbanicity, though of smaller magnitude, was observed for antidepressant use but not for cancer.</p><p><strong>Conclusions: </strong>\u0000 <b>The association between depression and RTW varied by municipality urbanicity, whereas no clear differences were observed for cancer.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"14034948261485828"},"PeriodicalIF":1.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effects of conspiracy beliefs, trust in government, and perceived government response on COVID-19 vaccination in European countries.","authors":"Ying-Chih Chuang, Rong-Xian Chen, Chyi-Huey Bai","doi":"10.1177/14034948261481314","DOIUrl":"https://doi.org/10.1177/14034948261481314","url":null,"abstract":"<p><strong>Aims: </strong>Although the effects of conspiracy beliefs and trust in government on COVID-19 vaccination behavior have been analyzed in numerous studies, the interrelationships between these factors and the mechanisms through which they influence vaccination behavior remain underexplored. We hypothesized that conspiracy beliefs are negatively associated with trust in government, which is subsequently and positively associated with attitudes toward and satisfaction with government response, ultimately affecting vaccination behavior.</p><p><strong>Methods: </strong>For this cross-sectional multilevel study, data were collected from the 10th round (2022) of the European Social Survey. Participants from 18 countries who completed the COVID-19 module of this survey were included in the analysis (<i>N</i> = 27,983). Data were analyzed using a two-step approach, combining generalized linear mixed models with random intercept and structural equation models.</p><p><strong>Results: </strong>Conspiracy beliefs were negatively associated with trust in government (β = -0.506). Furthermore, conspiracy beliefs (β = -0.125) and trust in government (β = 0.150) were negatively and positively associated with vaccination intention and behavior respectively. Both factors indirectly affected vaccination behavior through individuals' satisfaction with COVID-19 interventions and attitudes toward government response. Attitudes were more strongly associated with conspiracy beliefs (β = -0.237), whereas satisfaction was more strongly associated with trust in government (β = 0.509).</p><p><strong>Conclusions: </strong>\u0000 <b>Our study demonstrated the complex interrelationships among conspiracy beliefs, trust in government, and COVID-19 vaccination. Policymakers should invest in transparent, evidence-based communication strategies to counter misinformation during public health crises.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"14034948261481314"},"PeriodicalIF":1.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Greenspace, air pollution and respiratory health outcomes: a systematic review of cohort studies.","authors":"Mae Sofie Vance, Tyler Lane, Tingting Ye","doi":"10.1177/14034948261481328","DOIUrl":"https://doi.org/10.1177/14034948261481328","url":null,"abstract":"<p><strong>Background/objective: </strong>Exposure to greenspace is associated with improved health outcomes, with proposed mechanisms including improved local air quality and health effects that reduce personal susceptibility to air pollution. This systematic review synthesises cohort study evidence on whether greenspace protects against air pollution effects on respiratory-related health outcomes.</p><p><strong>Methods: </strong>We conducted a systematic review of cohort studies, searching Medline, Embase and Scopus databases published up to May 2026. Study quality was evaluated using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Fourteen studies met the inclusion criteria, all of which were rated as 'good' quality. Cohorts mostly originated from Europe, with outcomes including respiratory-related mortality, lung function, and non-infectious respiratory diseases. In general, exposure to greenspace was protective against air pollution-associated respiratory mortality, with effects more consistently detected through mediation than moderation.</p><p><strong>Conclusions: </strong>\u0000 <b>Residential greenspace appears to reduce the harm associated with air pollutants on respiratory health outcomes, including related mortality. The stronger association detected through mediation analysis suggests that the mechanism is through improvements in local air quality rather than the direct effects of greenspace on health, enhancing individual resilience to the effects of air pollution.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"14034948261481328"},"PeriodicalIF":1.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maja Eilertsen, Nikolai O Czajkowski, Tone K Omsland, Espen Røysamb, Ragnhild Bang Nes
{"title":"Wellbeing, mastery and work participation: Effects of the Five Ways to Wellbeing course-a randomized controlled trial.","authors":"Maja Eilertsen, Nikolai O Czajkowski, Tone K Omsland, Espen Røysamb, Ragnhild Bang Nes","doi":"10.1177/14034948261479465","DOIUrl":"https://doi.org/10.1177/14034948261479465","url":null,"abstract":"<p><strong>Background: </strong>Rising ill health, declining wellbeing, and absenteeism threaten societal sustainability amid an ageing population. Promoting health, wellbeing and work participation is essential. The Five Ways to Wellbeing course is a six-week programme designed to enhance wellbeing through five core activities: connecting, being active, taking notice, learning, and giving. A digital, shorter version has shown effectiveness in the general population, but the physical course has not been evaluated by randomized controlled trial in high-risk groups.</p><p><strong>Methods: </strong>This parallel two-group randomized controlled trial examined the effects of the Five Ways to Wellbeing course versus no course. Adults (⩾18 years old) receiving benefits through the Norwegian Labour and Welfare Administration were randomly assigned to the intervention or control group. The trial was non-blinded; participants were aware of group allocation because blinding was not feasible. Main outcomes were wellbeing, mastery and work participation, measured at baseline, post-intervention and six months. Multilevel analyses compared repeated measures across groups.</p><p><strong>Results: </strong>A total of 171 adults were randomized to the intervention (<i>n</i> = 87) or the control group (<i>n</i> = 84). Owing to attrition, data from 71 intervention and 46 control participants were included in the final analyses. No statistically significant differences in wellbeing, mastery or work participation were observed between groups.</p><p><strong>Conclusions: </strong><b>This underpowered trial found no statistically significant effects, limiting conclusions about the course's effectiveness. However, it provides insight into the challenges of conducting pragmatic randomized trials within routine welfare services.</b>Trial registration:ClinicalTrials.gov (ref. NCT04668560).</p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"14034948261479465"},"PeriodicalIF":1.7,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paz Lopez-Doriga Ruiz, Lars C Stene, Karianne Fjeld Løvaas, Grethe Åstrøm Ueland, Tone Vonheim Madsen, Kåre I Birkeland, Hanne Løvdal Gulseth, Robert Wiik, Kjersti Nøkleby, Inger Johanne Bakken
{"title":"Classification of type 1 diabetes and type 2 diabetes based on administrative registry data: a nationwide study from Norway.","authors":"Paz Lopez-Doriga Ruiz, Lars C Stene, Karianne Fjeld Løvaas, Grethe Åstrøm Ueland, Tone Vonheim Madsen, Kåre I Birkeland, Hanne Løvdal Gulseth, Robert Wiik, Kjersti Nøkleby, Inger Johanne Bakken","doi":"10.1177/14034948261460921","DOIUrl":"https://doi.org/10.1177/14034948261460921","url":null,"abstract":"<p><strong>Background: </strong>Type 1 diabetes (T1D) and type 2 diabetes (T2D) differ in health care needs. Precise prevalence estimates by type are important for health care planning.</p><p><strong>Data and methods: </strong>This validation study used Norwegian health registry data to develop a T1D/T2D classification method, using the Norwegian Diabetes Register for Adults (NDR-A) as reference standard. Our study population consisted of all individuals 18 years and older residing in Norway in 2022 (<i>N</i> = 4,315,563). We used Cohen's kappa to assess agreement between the classification method and the NDR-A.</p><p><strong>Results: </strong>The established classification method had three key steps: (a) T1D, based on insulin use and specialist health care T1D diagnoses, (b) T2D, based on specialist and primary health care T2D, and (c) T1D, based on primary health care T1D and insulin use, and no T2D. The overall agreement with NDR-A diagnosis was 95.2% for T1D and 97.6% for T2D. For T1D, agreement was 97% or higher in age-groups 18-39 and 40-59, 87.6% for those aged 60-79 and 69.4% for individuals older than 80. For T2D, the agreement was 97% or higher for age-groups 40 and above, and 92.1% for those aged 18-39. Applying the classification method to total population data showed that, in 2022, among 4,315,563 individuals aged 18 and older living in Norway, 31,264 had T1D (0.72%) and 239,120 had T2D (5.5%).</p><p><strong>Conclusions: </strong>\u0000 <b>Our registry-based classification agreed well with the NDR-A, implying that administrative health registry data are suitable in epidemiological and health services studies of T1D and T2D.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"14034948261460921"},"PeriodicalIF":1.7,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}